Teicoplanin Dosing Strategy for Treatment ofStaphylococcus aureusin Korean Patients with Neutropenic Fever

Purpose: The present study was conducted to determine and compare the target attainment rate (TAR) between microorganism-nonspecific (C trough ) and microorganism-specific (AUC 24 /MIC) targets over two weeks of teicoplanin administration according to several dose regimens for the treatment of Staphylococcus aureus in Korean patients with neutropenic fever.Materials and Methods: One thousand virtual concentrations were obtained for each dose using the population pharmacokinetic parameters of teicoplanin adopted from a published study.Simulation of 1,000 virtual MICs was performed using the MICs of 78 clinical isolates of S. aureus collected from a hospital in Korea.Thereafter, these simulated MICs were randomly allocated to 1,000 virtual patients in whom the TARs for AUC 24 /MIC >125 [or 345] and C trough >10 [or 20] mg/L were determined.The relationship of the maintenance dose with the steady-state TAR was predicted with respect to the AUC 24 /MIC >125 [or 345] using logistic analysis.Results: The standard dose regimen of teicoplanin showed TARs of about 70% [or 33%] and 70% [or 20%] at steady-state in cases with AUC 24 /MIC >125 [or 345] and C trough >10 [or 20] mg/L, respectively.Conclusion: The current standard dose regimen was predicted to be insufficient to adequately treat S. aureus in Korean patients with neutropenic fever.To assure at least an 80% TAR in this population, dose adjustment of teicoplanin should be considered.